Patient Perspectives on Telemedicine During the COVID-19 Pandemic.

BACKGROUND: Patients received care over telemedicine during the COVID-19 pandemic, and their perspective is useful for hand surgeons. METHODS: Online surveys were sent October-November 2020 to 497 patients who received telemedicine care. Questions were free-response and multi-item Likert scales asking about telehealth in general, limitations, benefits, comparisons to in-person visits, and opinions on future use. RESULTS: The response rate was 26% (n = 130). Prior to the pandemic, 55% had not used telemedicine for hand surgery consultation. Patients liked their telemedicine visit and felt their provider spent enough time with them (means = 9/10). In all, 48% would have preferred in-person visits despite the pandemic, and 69% would prefer in-person visits once the pandemic concludes. While 43% had no concerns with telemedicine, 36% had difficulties explaining their symptoms. Telemedicine was easy to access and navigate (M = 9/10). However, 23% saw telemedicine of limited value due to the need for an in-person visit soon afterward. Of these patients, 46% needed an in-person visit due to inadequate physical examination. Factors that make telemedicine more favorable to patients included convenience, lack of travel, scheduling ease, and time saved. Factors making telemedicine less favorable included need for in-person examination or procedure, pain assessment, and poor connectivity. There was no specific appointment time the cohort preferred. Patient recommendations to improve telemedicine included decreasing wait times and showing patient queue, wait time, or physician status online. CONCLUSIONS: Telemedicine was strongly liked by patients during the COVID-19 pandemic. However, nearly 70% of patients still preferred in-person visits for the future.

Impact of COVID-19 on Elective Orthopaedic Surgery Outcomes During the Peak of the Pandemic, an Uptick of Complications: An Analysis of the ACS-NSQIP.

INTRODUCTION: Since the World Health Organization declared a pandemic in March 2020, COVID-19 has pressured the healthcare system. Elective orthopaedic procedures for American seniors were canceled, delayed, or altered because of lockdown restrictions and public health mandates. We sought to identify differences in the complication rates for elective orthopaedic surgeries before and atfter the pandemic onset. We hypothesized that complications increased in the elderly during the pandemic. METHODS: We conducted a retrospective analysis of the American College of Surgeons-National Surgical Quality Improvement Program database in patients older than 65 years undergoing elective orthopaedic procedures from 2019 (prepandemic) and April to December 2020 (during the pandemic). We recorded readmission rates, revision surgery, and 30-day postoperative complications. In addition, we compared the two groups and adjusted for baseline features with standard multivariate regression. RESULTS: We included 146,430 elective orthopaedic procedures in patients older than 65 years (94,289 before the pandemic and 52,141 during). Patients during the pandemic had a 5.787 times greater chance of having delayed wait time to the operating room (P < 0.001), a 1.204 times greater likelihood of readmission (P < 0.001), and a 1.761 times increased chance of delayed hospital stay longer than 5 days (P < 0.001) when compared with prepandemic. In addition, during the pandemic, patients were 1.454 times more likely to experience any complication (P < 0.001) when compared with patients prepandemic undergoing orthopaedic procedures. Similarly, patients were also 1.439 times more likely to have wound complication (P < 0.001), 1.759 times more likely to have any pulmonary complication (P < 0.001), 1.511 times more likely to have any cardiac complication (P < 0.001), and 1.949 times more likely to have any renal complication (P < 0.001). CONCLUSION: During the COVID-19 pandemic, elderly patients faced longer wait times within the hospital and increased odds of complications after elective orthopaedic procedures than similar patients before the pandemic.

Impact of COVID-19 on Elective Orthopaedic Surgery Outcomes During the Peak of the Pandemic, an Uptick of Complications: An Analysis of the ACS-NSQIP.

INTRODUCTION: Since the World Health Organization declared a pandemic in March 2020, COVID-19 has pressured the healthcare system. Elective orthopaedic procedures for American seniors were canceled, delayed, or altered because of lockdown restrictions and public health mandates. We sought to identify differences in the complication rates for elective orthopaedic surgeries before and atfter the pandemic onset. We hypothesized that complications increased in the elderly during the pandemic. METHODS: We conducted a retrospective analysis of the American College of Surgeons-National Surgical Quality Improvement Program database in patients older than 65 years undergoing elective orthopaedic procedures from 2019 (prepandemic) and April to December 2020 (during the pandemic). We recorded readmission rates, revision surgery, and 30-day postoperative complications. In addition, we compared the two groups and adjusted for baseline features with standard multivariate regression. RESULTS: We included 146,430 elective orthopaedic procedures in patients older than 65 years (94,289 before the pandemic and 52,141 during). Patients during the pandemic had a 5.787 times greater chance of having delayed wait time to the operating room (P < 0.001), a 1.204 times greater likelihood of readmission (P < 0.001), and a 1.761 times increased chance of delayed hospital stay longer than 5 days (P < 0.001) when compared with prepandemic. In addition, during the pandemic, patients were 1.454 times more likely to experience any complication (P < 0.001) when compared with patients prepandemic undergoing orthopaedic procedures. Similarly, patients were also 1.439 times more likely to have wound complication (P < 0.001), 1.759 times more likely to have any pulmonary complication (P < 0.001), 1.511 times more likely to have any cardiac complication (P < 0.001), and 1.949 times more likely to have any renal complication (P < 0.001). CONCLUSION: During the COVID-19 pandemic, elderly patients faced longer wait times within the hospital and increased odds of complications after elective orthopaedic procedures than similar patients before the pandemic.

The Role of E-Accounting Adoption on Business Performance: The Moderating Role of COVID-19

In the last decade, information systems (ISs) have made dynamic developments in light of their ability to enhance the performances of businesses. In relation to this, an organization that is effectively and efficiently managed often displays optimum performance using financial systems such as electronic accounting (e-accounting). Thus, essentially, e-accounting is utilized for the automation of operational processes and for improving business efficiency and performance. More currently, e-accounting dynamic development has laid credence to the performance of businesses in a way that the influence cannot be exaggerated. Nevertheless, past studies evidenced that successful e-accounting depends on critical success factors, and hence this study primarily aims to conduct an evaluation of e-accounting using DeLone and McLean's information system model (DM ISM) among firms in Jordan. More specifically, this study determines the influence of information quality, system quality, service quality, system usage, and user satisfaction on business performance. The current study adopted a quantitative method, applying a self-administered survey questionnaire for the purpose of data collection from 104 e-accounting users. This study employed partial least squares structural equation modeling (PLS-SEM) to validate the data, and based on the findings, system quality and information quality affect system use;service quality of e-accounting had no significant impact on use, but e-accounting use had a significant influence on the satisfaction of users. Moreover, e-accounting system use and user satisfaction positively influence business performance. This study is an extension of the current IS literature, particularly of those focused on determining the effects of e-accounting benefits. This study validated the proposed model in the context of Jordanian firms and contributes to both the literature on and practice of e-accounting. This study provided implications, limitations, and recommendations for future research.

Assessing the Intention to Adopt Cloud Accounting during COVID-19

The information technology (IT) revolutionization aside with the emergence of COVID-19 have catalyzed cloud-computing services and systems with multiple end-user benefits for online business management, specifically in the accounting discipline. For example, cloud accounting enables the significant reduction of organisational IT investment with flexible access to a large group of scalable resources. The cloud accounting enables small and medium size enterprises (SMEs) to independently engage in fundamental bookkeeping responsibilities rather than hiring external auditors for the same services. As cloud-based accounting adoption remains in the preliminary stage within Jordanian businesses, this study applied the technology, organisation, and environment model to explore cloud accounting among Jordanian SMEs. The study data were gathered from 156 Jordanian SME owners or managers with a structured online survey questionnaire. The recommended study framework encompassed seven determinants that influenced the cloud accounting adoption intention. Resultantly, except Perceived knowledge uncertainty factor, the proposed hypotheses were supported as the aforementioned factors (relative advantages, security concerns, top management support, organizational readiness, competitor's intensity and suppliers computing support) positively and significantly influenced the cloud accounting of Jordanian SMEs. The study outcomes could facilitate IT field decision-makers and practitioners by investigating an actual cloud accounting case based on the essentiality of its application.

Influence of Digital Accounting System Usage on SMEs Performance: The Moderating Effect of COVID-19

In the literature, studies have evidenced the efforts adopted by firms to develop digital technology with the hope of achieving sustainable decisions and competitive performance. However, studies have yet to provide an extensive explanation of the mechanisms used by firms in their digital technology adoption to impact and enhance value, particularly among small and medium enterprises (SMEs). In this regard, accounting information has served as a fundamental basis for business decision-making and the extensive use of digital technology has paved the way for the efficiency and effectiveness of accounting functions in modifying information relating to such functions. More specifically, a digital accounting system (DAS) enables the reporting and processing of large transaction amounts and generates the data required for analysis. However, despite these advantages, SMEs have been slow in their adoption and usage of DASs. Accordingly, this study drew upon resource-based view theory and the technology-organization-environment framework to propose an integrated model for examining the determinants and impact of using DAS among SMEs. The proposed model encapsulates the use and performance aspect of DAS. The study utilized a self-administered survey questionnaire as the primary data collection instrument. Data from 183 SMEs in Jordan were analyzed using partial least squares-structural equation modeling. The findings reveal that compatibility, organizational readiness, top management support and government support all had significant effects on DAS usage, which, in turn, had a positive and significant effect on DAS performance. With regard to the moderating effects, COVID-19 was found to have a moderating role on the DAS usage-DAS performance relationship. The study findings explain the way firms can enhance their DAS use to obtain optimum performance, thereby contributing to the literature on the antecedents and effects of using current information technology/information systems. The study recommends that the government of Jordan prepare and carry out a campaign concerning the importance of DASs for SMEs.

Telemedicine Use during the COVID-19 Pandemic: Results of an International Survey

Objective  The aim of the study is to survey hand surgeons' perspectives on telemedicine during the coronavirus disease 2019 (COVID-19) pandemic and intended applications after the pandemic. Methods  Online surveys were sent to 285 Canadian and American surgeons in late April and early May 2020. Results  Response rate was 63% (180)—84% (152) American and 16% (28) Canadian. Forty-three percent (76) of respondents were in private practice, 36% (64) academics, 13% (24) privademics, and 6% (12) hospital employed. The most common telemedicine platform was Zoom. During the pandemic, 42% of patient visits were conducted via telemedicine;however, 37% required a subsequent in-person office visit. The most common complaint by surgeons was the inability to provide routine in-office procedures. The most beneficial feature was ease of use, and the most frustrating feature was connectivity difficulty. Time spent was similar to in-person visits, and surgeons were likely to recommend their platforms. Surgeons were neutral about using telehealth in the future and were most likely to use it for follow-up visits. New patient visits for traumatic injuries or fractures were of limited value. Canadians used telemedicine for a greater proportion than Americans (50 vs. 40%, p <0.05) and spent more time than in-person visits (7/10 vs. 5/10, p <0.05). Americans were more likely to use telemedicine for postoperative follow-up visits (6/10 vs. 4/10, p <0.05) and in mornings before clinic opens (4/10 vs. 2/10, p <0.05). Private practices were more likely to use telemedicine for future allied health provider visits than all other practice types ( p <0.05). Conclusion  Telemedicine comprised nearly half of patient encounters during the COVID-19 pandemic, but limitations remain.

A First Look at Privacy Analysis of COVID-19 Contact-Tracing Mobile Applications.

Today's smartphones are equipped with a large number of powerful value-added sensors and features, such as a low-power Bluetooth sensor, powerful embedded sensors, such as the digital compass, accelerometer, GPS sensors, Wi-Fi capabilities, microphone, humidity sensors, health tracking sensors, and a camera, etc. These value-added sensors have revolutionized the lives of the human being in many ways, such as tracking the health of the patients and the movement of doctors, tracking employees movement in large manufacturing units, monitoring the environment, etc. These embedded sensors could also be used for large-scale personal, group, and community sensing applications especially tracing the spread of certain diseases. Governments and regulators are turning to use these features to trace the people's thoughts to have symptoms of certain diseases or viruses, e.g., COVID-19. The outbreak of COVID-19 in December 2019, has seen a surge of the mobile applications for tracing, tracking, and isolating the persons showing COVID-19 symptoms to limit the spread of the disease to the larger community. The use of embedded sensors could disclose private information of the users, thus potentially bring a threat to the privacy and security of users. In this article, we analyzed a large set of smartphone applications that have been designed to contain the spread of the COVID-19 virus and bring the people back to normal life. Specifically, we have analyzed what type of permission these smartphone apps require, whether these permissions are necessary for the track and trace, how data from the user devices are transported to the analytic center, and analyzing the security measures these apps have deployed to ensure the privacy and security of users.

Epidemiology, virology and clinical aspects of hantavirus infections: an overview.

At the end of 2019 and 2020s, a wave of coronavirus disease 19 (COVID-19) epidemics worldwide has catalyzed a new era of 'communicable infectious diseases'. However, the world is not currently prepared to deal with the growing burden of COVID-19, with the unexpected arrival of Hantavirus infection heading to the next several healthcare emergencies in public. Hantavirus is a significant class of zoonotic pathogens of negative-sense single-stranded ribonucleic acid (RNA). Hemorrhagic renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS) are the two major clinical manifestations. Till date, there is no effective treatments or vaccines available, public awareness and precautionary measures can help to reduce the spread of hantavirus disease. In this study, we outline the epidemiology, virology, clinical aspects, and existing HFRS and HCPS management approaches. This review will give an understanding of virus-host interactions and will help for the early preparation and effective handling of further outbreaks in an ever-changing environment.